• Volume 17,Issue 12,2018 Table of Contents
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    • >Clinical Research
    • Prophylactic analgesic effects of dexmedetomidine in combination with dezocine in the hypertensive elderly patients undergoing thoracoscopic surgery

      2018, 17(12):881-885. DOI: 10.11915/j.issn.1671-5403.2018.12.204

      Abstract (1713) HTML (0) PDF 419.77 K (1069) Comment (0) Favorites

      Abstract:Objective To assess the prophylactic analgesic effects of dexmedetomidine in combination with dezocine in the hypertensive elderly patients undergoing thoracoscopic surgery. Methods Eighty patients of both genders (age, 65-80 years) scheduled for elective thoracoscopic lobectomy under general anesthesia were randomly divided into 4 groups:dexmedetomidine group (DEX group), dezocine group (DEZ group), dexmedetomidine+dezocine group (DD group), and control group (C group). Patients in DEX group received intraoperative intravenous infusion of dexmedetomidine at 0.4 μg/(kg·h). In DEZ group, dezocine 0.1 mg/kg was injected intravenously 15 min prior to the induction of anesthesia and at the time of suturing. In DD group, dezocine 0.1 mg/kg was injected intravenously 15 min prior to the induction of anesthesia, followed by intraoperative intravenous infusion of dexmedetomidine 0.4 μg/(kg·h) and subsequent intravenous injection of dezocine at the time of suturing. Normal saline of equal volume was administered in C group. Patient-controlled intravenous analgesia (PCIA) was started for all patients when they were transferred to the Post-anesthesia Care Unit (PACU). Venous blood samples were collected for measuring the plasma norepinephrine (NE) 20 min prior to the induction of anesthesia (T1), at the time of suturing (T2), immediately post-extubation (T3), 5 min post-extubation(T4) and 30 min post-extubation (T5). The Ramsay scores at T4, T5 and 60 min post-extubation and degree of emergence agitation were recorded.Resting visual analogue score (VAS) at postoperative 1 h (T7), 4 h (T8), 12 h (T9), and 24 h (T10), and frequency of PCIA button pressing and consumption of analgesics during postoperative 24 hours were also recorded. The postoperative adverse reactions were observed for all the patients. SPSS statistics 21.0 was used for data analysis. Results The plasma NE was significantly decreased in DD group than DEX group and DEZ group from T2 to T5 (P<0.05). Ramsay scores at T4-T6 were significantly higher and the emergence agitation during recovery period significantly lower in DD group than DEX group and DEZ group (P<0.05). VAS at T7-T10, frequency of PCIA button pressing and consumption of analgesics during postoperative 24 hours were significantly lower in DD group than DEX group and DEZ group (P<0.05). The incidences of hypertension, nausea and vomiting were significantly lower in DD group than DEX group and DEZ group (P<0.05). Conclusion Dexmedetomidine in combination with dezocine exerts satisfactory prophylactic analgesic effects in the hypertensive elderly patients undergoing thoracoscopic surgery, relieving the stress reaction, decreasing the emergence agitation and reducing the postoperative pain.

    • Polypharmacy and medication reconciliation in the hospitalized elderly patients near the end of life

      2018, 17(12):886-889. DOI: 10.11915/j.issn.1671-5403.2018.12.205

      Abstract (1239) HTML (0) PDF 383.78 K (862) Comment (0) Favorites

      Abstract:Objective To analyze the clinical characteristics and medication in the hospitalized elderly patients near the end of life. Methods Based on 1-year mortality prediction index, a total of 99 elderly patients (aged ≥70 years) were enrolled in the study, who were treated in the Department of Geriatrics, Peking Union Medical College Hospital from January 2015 to December 2017. Data were collected and analyzed of the characteristics of chronic diseases, geriatric syndrome, number of medications taken in hospital, number of medications taken out of hospital after medication reconciliation and number of medications taken for cardiovascular and cerebrovascular diseases. SPSS statistics 21.0 was used for data analysis. Depending on data type, Student′s t test or McNemar matching χ2 test were performed for comparison. Results One-year mortality index for the 99 patients was 7-16 (9.8±2.3)score. The top three chronic diseases were malignant tumors (76.8%), hypertension (56.6%) and coronary heart disease (39.4%). The top three geriatric syndromes were polypharmacy (≥5 taken out of hospital; 72.7%), malnutrition or nutrition risk (72.7%) and constipa-tion (45.4%). The number of medications after medication reconciliation on discharge (7.4±3.9) increased significantly as compared with those used on admission (4.7±3.7; P<0.05), with increased use of symptomatic drugs such as vitamins, laxatives, analgesics, respiratory system drugs, antiacids, iron supplements and antidepressants and decreased use of antihypertensives (P<0.05). Of 48 patients with cardiovascular and/or cerebrovascular diseases, 25 (52.1%) were taking antiplatelet drugs and 32 (66.7%) were taking statins on discharge; 23 did not take antiplatelet drugs because of high risk of bleeding or active hemorrhage, and 16 did not take statins because of disability, high risk of associated adverse reactions, new myalgia or new abnormal liver function. Conclusion The rate of symptomatic drugs increases after medication reconciliation in the elderly patients near the end of life and strategies for cardiovascular diseases need to be formulated in accordance with the patient′s own condition.

    • Effect of dexmedetomidine on the perioperative stress response and postoperative cognition in the elderly patients receiving spinal surgery

      2018, 17(12):890-894. DOI: 10.11915/j.issn.1671-5403.2018.12.206

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      Abstract:Objective To investigate the effect of dexmedetomidine on the perioperative stress response and postoperative cognition in the elderly patients undergoing spinal surgery. Methods A total of 120 elderly patients were selected for the study, who received spinal surgery in the Department of Anesthesiology of the First Affiliated Hospital of Hebei North University from April 2016 to November 2017. They were randomly divided into dexmedetomidine group (group D) and normal saline group (group S) with 60 each. Venous access was established in both groups. In group D, a loading dose of dexmedetomidine was pumped at 0.5 μg/kg for 10 min, and dexmedetomidine was continuously pumped at 0.3 μg/(kg·h) until 30 min before the end of the operation. In group S, saline of the equal volume was given via intravenous infusion.The levels of stress factors and cognitive function were compared between two groups at T0 (1 d before operation), T1 (4 h after operation), T2 (24 h after operation) and T3 (48 h after operation). SPSS statistics 19.0 was used for data analysis, and repeated measures analysis of variance and Student′s t test were performed for comparison between groups. Results Cortisol and interleukin-6 (IL-6) in both groups at T1 and T2 were higher but angiotensin Ⅱ (Ang Ⅱ) at those time points was lower than at T0. Group S had higher cortisol, IL-6 and Ang Ⅱ than group D at T1 and T2, the difference being statistically significant (P<0.05). For both groups, MMSE scores were lower at T1 and T2 than at T0. Compared with group S, group D had higher MMSE scores at T1 [(25.34±2.64) vs (20.01±2.01)] and T2 [(25.45±2.71) vs (21.12±2.14)] but lower PSQI scores at T1 [(7.67±1.25) vs (9.68±1.23)] and T2 [(2.86±1.53) vs (2.99±1.55)], the difference being statistically significant (P<0.05). Conclusion Dexmedetomidine has effect in alleviating perioperative stress response and postoperative cognitive dysfunction in the elderly patients with spinal surgery.

    • Related factors of multiple drug resistant infection in aged patients with hypostatic pneumonia:analysis of 622 cases

      2018, 17(12):895-900. DOI: 10.11915/j.issn.1671-5403.2018.12.207

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      Abstract:Objective To analyze the risk factors of multiple drug resistant bacteria (MDRB) infection in the elderly patients with hypostatic pneumonia in order to provide reference for clinical diagnosis and treatment. Methods A retrospective analysis was carried out on 622 elderly hospitalized patients with pendulous pneumonia admitted in the Third Affiliated Hospital of Guizhou Medical University from February 2012 to July 2018. According to whether the strains of MDRB were isolated from their clinical infection specimens, they were divided into MDRB group and non-MDRB group. SPSS statistics 20.0 was used to perform the statistical analysis. Chi-square test was employed for intergroup comparison. The risk factors of MDRB infection were analyzed with univariate and multivariate logistic regression analyses. Results The infection rate of MDRB was 34.43%(167/485). Univariate analysis showed that age (>70 years), history of chronic pulmonary infection, history of chronic cardio-cerebrovascular disease, history of diabetes mellitus, course of disease (>15 d), APACHE Ⅱ score >20, coma, smoking history, and time of antibiotic usage (>7 d), types of applied antibiotics (≥3) and blood glucose (≥11.1 mmol/L) were the risk factors of MDRB infection in the elderly (P<0.05). Semi-sitting position, aerosol inhalation and oral nursing were the protective factors of the infection (P<0.05). Logistic regression analysis presented that the history of chronic pulmonary infection (OR=3.472,5%CI 1.866-6.461; P=0.000) and combined use of antimicrobial agents (≥3) (OR=3.760,5%CI 1.775-7.968; P=0.038) were independent risk factors for MDRB infection. Aerosol inhalation (OR=0.624, 95%CI0.400-0.974;P=0.000) and oral care (OR=0.256,5%CI0.161-0.408; P=0.001) were the protective [JP+1]factors of MDRB infection in the aged patients with pendulous pneumonia. Conclusion MDRB infection in elderly patients with pendulous pneumonia is related to many factors. Clinical attention should be paid to these patients, and rational use of antimicrobial agents, oral care and comprehensive measures such as aerosol inhalation and sputum drainage can reduce the infection of MDRB.

    • Clinical characteristics and medications for hospital-acquired acute kidney injury in the elderly patients

      2018, 17(12):901-905. DOI: 10.11915/j.issn.1671-5403.2018.12.208

      Abstract (1605) HTML (0) PDF 403.90 K (903) Comment (0) Favorites

      Abstract:Objective To investigate the clinical characteristics of and medications for hospital-acquired acute kidney injury (HA-AKI) in the patients in geriatric wards. Methods A retrospective analysis was made of 7029 hospitalized patients aged over 60 years in the Geriatric Ward of Guangdong General Hospital from January 2012 to December 2016. According to the criteria of serum creatinine (SCr) change in Kidney Disease:Improving Global Outcomes(KDIGO), patients were divided into HA-AKI group (n=1830)and non-AKI group (n=4650). The 2 groups were compared in clinical characteristics, use of drugs that may cause nephrotoxicity, and relationship between use of drugs and discharge outcomes. SPSS statistics 20.0 was used for statistical analysis. Depending on data type, Student′s t test, χ2 or trend tests were used for comparison. Results The incidence of HA-AKI was 26.03%(1830/7029). Compared with non-AKI group, HA-AKI group had more advanced age, higher baseline SCr, higher percentage of patients with estimated glomerular filtration rate (eGFR)<60 ml/(min·1.73 m2), higher incidence of chronic kidney disease, diabetes mellitus, connective tissue disease, cerebrovascular disease, and peripheral vascular disease, and higher Charlson comorbidity index (CCI) score≥3 (P<0.001). The HA-AKI groups also had a higher proportion of nephrotoxic drugs such as diuretic and dehydrating agent, adrenergic receptor agonists, anti-heart failure drugs and aminoglycosides than the non-AKI group. In addition, the HA-AKI group were higher than the non-AKI [JP+1]group in the percentage of patients requiring transfer to ICU [6.0%(110/1830) vs1.5%(68/4650)],cardio-pulmonary resuscitation [0.7%(12/1830) vs 0.3%(12/4650)] and dialysis [2.0% (36/1830) vs 0.1%(1/4650)], length of hospital stay [(15.9±6.5) vs (13.6±6.5)d] and hospitalization costs [(5.7±4.0)×104 vs (4.4±2.9)×104 RMB¥]and in-hospital mortality [11.3%(207/1830) vs 0.9%(41/4650)] (P<0.05). Moreover, the use of diuretic and dehydrating agent, angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs), non-steroidal anti-inflammatory drugs (NSAIDs), adrenergic receptor agonists, aminoglycosides, and chemotherapeutic agent continued to increase even after the occurrence of HA-AKI, and the greater the number of the drugs used, the worse the tendency of the in-hospital adverse outcomes (P<0.001). Conclusion Incidence of HA-AKI is high in geriatric wards, which is attributable to the higher age, more comorbidities and number of nephrotoxic drugs used before the onset, causing serious outcomes and increasing burden on medical care.

    • Change of biochemical bone turnover markers in the middle-aged and elderly men with type 2 diabetes mellitus and osteoporosis

      2018, 17(12):906-910. DOI: 10.11915/j.issn.1671-5403.2018.12.209

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      Abstract:Objective To investigate bone turnover markers and associated factors in the middle-aged and elderly men with type 2 diabetes mellitus (T2DM) and osteoporosis. Methods According to the 1998 WHO diagnostic criteria for osteoporosis and the 1990 WHO diagnostic criteria for diabetes, 80 middle-aged and elderly men were divided into osteoporosis group (OP, n=40) and diabetic osteoporosis group (DOP, n=40). All the patients received tests for bone turnover markers, serum calcium (Ca), serum phosphor(P), parathyroid hormone(PTH),25-OH vitamin D (25OHD) and other biomarkers of glucose metabolism. Statistical analysis was done using SPSS statistics 22.0. Depending on data type, Student′s t test, Pearson linear correlation or multivariate regression was performed. Results There were no obvious differences between the OP and DOP groups in BMD of L1-4[(0.960±0.281) vs (0.970±0.126)g/cm2,P=0.22], femoral neck [(0.895±0.162) vs (0.895±0.119)g/cm2,P=0.99] and total hip [(0.784±0.143) vs (0.748±0.112)g/cm2, P=0.85].Compared with OP group, DOP group had lower osteocalcin (OC) [(16.69±8.91) vs (22.71±13.12)ng/ml,P=0.019], P1NP [(43.04±20.29) vs (53.64±24.08)ng/ml,P=0.037] and 25OHD [(12.80±5.54) vs (16.58±8.00)ng/ml,P=0.044], but higher CTX [(0.64±0.22) vs (0.49±0.30)ng/ml,P=0.013], the differences being statistically significant. Correlation analysis found that OC and P1NP were negatively correlated with HbA1c and the duration of diabetes, and that CTX was positively correlated with HbA1c and the duration of diabetes but negatively correlated with BMD of total hip (P<0.05). Regression analysis showed that HbA1c was an independent risk factor for OC and P1NP, and that CTX was affected by HbA1c and BMD of total hip. Conclusion Patients with T2DM have decreased bone formation and increased bone absorption which was gradually exacerbated with the deterioration of blood glucose and progression of diabetes. Vitamin D deficiency is worse in patients with diabetic osteoporosis.

    • Clinical value of procalcitonin in febrile patients with lung cancer

      2018, 17(12):911-914. DOI: 10.11915/j.issn.1671-5403.2018.12.210

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      Abstract:Objective To evaluate procalcitonin (Pct), white blood cell(WBC), neutrophil percentage(N), and high sensitivity C-reactive protein(hs-CRP) in the diagnosis of febrile patients with lung cancer. Methods A total of 113 febrile patients with lung cancer were enrolled in the study, who were treated in the Department of Oncology of Shijingshan Hospital. Based on the causes of fever, the patients were divided into fever-induced-by-inflammation (FIBI) group (n=71) and fever-induced-by-tumor (FIBT) group (n=42). The former was further divided into the sepsis subgroup (28 cases) and non-sepsis subgroup (43 cases). Also enrolled in the study as control group were 20 patients with lung cancer without fever and inflammation, who were treated during the same period. Blood samples were obtained for Pct, WBC, N and hs-CRP after their admission to the hospital and cure of infection. SPSS statistics 16.0 was used for data analysis. Spearman analysis was performed to investigate the relationships between variables. Receiver operating characteristic (ROC) curve was adopted to analyze the value of Pct in diagnosis of infection in febrile patients with lung cancer. Results Pct was significantly higher in the FIBI group than both the FIBT group (Z=5.101, P<0.001) and the control group(Z=5.169, P<0.001), and it was also significantly higher in non-sepsis group than in the FIBT group (Z=4.334, P<0.001). Pct was positively correlated with WBC (r=0.352, P=0.003), N (r=0.385, P=0.001), and hs-CRP (r=0.427, P=0.002) in the FIBI group. Using FIBT group as control, area under ROC curve (AUC) of Pct for the FIBI group was 0.907(95%CI 0.833-0.982), with the optimal cutoff value being 0.53 ng/ml, a sensitivity of 0.833 and a specificity of 0.857. Conclusion Pct is valuable in the differential diagnosis of fever induced by tumor and inflammation in the patients with lung cancer.

    • Efficacy of low-dose ticagrelor in the treatment of acute coronary syndrome in the elderly patients with chronic renal insufficiency

      2018, 17(12):915-918. DOI: 10.11915/j.issn.1671-5403.2018.12.211

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      Abstract:Objective To investigate the efficacy and safety of low-dose ticagrelor in the treatment of acute coronary syndrome (ACS) in the elderly patients with chronic renal insufficiency (CRI). Methods A total of 148 consecutive inpatients (aged≥75 years) with ACS and CRI were enrolled in the study, who were admitted to the Department of Cardiology of the 986th Hospital of the PLA Air Force from October 2016 to February 2017. Patients were divided into low-dose ticagrelor group (LD group; 45 mg/once, twice/d; n=52) and standard-dose ticagrelor group (SD group; 90 mg/once, twice/d; n=96). Thromboelastography (TEG) was performed 3 days after oral administration. The 2 groups were compared in the inhibition rate of platelet aggregation (IPA) induced by ADP, and the incidence of major adverse cardiac and cerebrovascular events (MACCE) and hemorrhage events during a follow-up of 12 months. The data were analyzed using SPSS statistics 19.0. Student′s t test or χ2 test was performed for comparison. Results IPA induced by ADP in the SD group was higher than that in the LD group [(83.4±2.5)% vs (67.3±4.7)%, P=0.043], but there was no significant difference with IPA was fewer than 50% between 2 groups[13.5%(7/52) vs 5.2%(5/96),P=0.219]. No significant difference was found between the 2 groups in the incidence of MACCE at month 12 [19.2%(10/52) vs13.5(13/96),P=0.476]. The incidence of massive hemorrhage in the LD group was significantly lower than that in the SD group [9.6%(5/52) vs 24.0%(23/96), P=0.033]. Conclusion Low dose of ticagrelor can be as effective as standard dose in antiplatelet action, reducing the risk of bleeding events and maintaining a balance between ischemia and hemorrhage.

    • Efficacy of Chaihu Shugan powder combined with rabeprazole in the treatment of peptic ulcer in the elderly

      2018, 17(12):919-922. DOI: 10.11915/j.issn.1671-5403.2018.12.212

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      Abstract:Objective To analyze clinical efficacy of Chaihu Shugan powder combined with rabeprazole in the treatment of peptic ulcer in the elderly. Methods A total of 126 senile patients with peptic ulcer were selected for the study, who were treated in the Department of Gastroenterology, People′s Hospital of Dianjiang County. The patients were randomized into the control group and the observation group with 63 in each. The two groups were treated with rabeprazole-based triple therapy, with Chaihu Shugan Powder added into the therapeutic regimen for the observation group. After 4 weeks of continuous treatment, comparisons were made between the two groups in the aspects of efficacy, levels of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), epidermal growth factor (EGF) and transforming growth factor-alpha (TGF-α) before and after the treatment, and adverse reactions. Data was processed using SPSS statistics 13.0. Depending on data type, Student′s t test or χ2 test was performed for comparison between groups. Results Compared with control group, the observation group had significantly lower level of serum IL-6 [(3.45±1.08) vs (4.28±1.76)μg/L] and TNF-α [(9.35±2.79) vs (10.64±3.05)μg/L] but significantly higher level of EGF [ (0.84±0.26) vs (0.72±0.22)ng/ml] and TGF-α [(7.55±1.93) vs (6.01±1.86)μg/ml], the differences being statistically significant (P<0.05). The total effective rate was 87.30% in the control group as against 98.41% in the observation group with significant difference (P<0.05). The clearance rate of Helicobacter pylori in the observation group was significantly higher than that in the control group (92.06% vs 71.43%; P<0.05). The incidence of adverse reactions was 15.87% in the control group and 14.28% in the observation group with no significant difference (P>0.05). Conclusion Chaihu Shugan powder combined with rabeprazole has definite efficacy in the treatment of peptic ulcer in the elderly, alleviating inflammation, increasing the level of growth factor, and promoting ulcer healing.

    • Correlation between walking function and bowel preparation for colonoscopy in the elderly patients

      2018, 17(12):923-926. DOI: 10.11915/j.issn.1671-5403.2018.12.213

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      Abstract:Objective To investigate the correlation between the walking function status and the quality of bowel preparation for colonoscopy in the elderly patients. Methods Enrolled in this study were 153 elderly inpatients undergoing colonoscopy in our hospital from January 2017 to March 2018. Assessment of the walking function was performed using the Barthel index before the procedure, and the patients were divided into normal walking group (n=82) and abnormal walking group (n=71) based on walking independence. The same bowel preparation was performed for both groups, and intestinal cleansing was recorded and cleaning efficiency was calculated. SPSS statistics 19.0 was used for analysis. Depending on data type, independent sample t test or Chi-square test was used for com-parison between groups. Correlation analysis was performed using Spearman rank correlation test. Results Significantly more patients in the normal walking group than in the abnormal walking group [87.8%(72/82) vs 63.4%(45/71), P<0.01] finished intestinal cleanser. In the patients who did not finish intestinal cleanser, the proportion of those intolerant frequent defecation in the normal walking group was significantly lower than that in the abnormal walking group [(8.54%(7/82) vs 30.99%(22/71), P=0.001]. However, the proportion of those who did not finish intestinal cleanser due to adverse reactions had no statistically significant difference between the 2 groups [3.66%(3/82) vs 5.63%(4/71), P=0.705]. Spearman rank correlation analysis showed that walking function was positively correlated with intestinal cleanliness (r=0.333, P<0.01). Conclusion Walking function status is correlated to the quality of bowel preparation in the elderly patients before colonoscopy. Difficulty in walking affects the quality of bowel preparation.

    • >Clinicopathological Conference
    • Complicated hemodialysis vascular access in an elderly patient

      2018, 17(12):931-934. DOI: 10.11915/j.issn.1671-5403.2018.12.216

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      Abstract:The number of the elderly patients receiving hemodialysis increase with the social and economic development, for whom vascular access is critical. However, it is difficult to establish a vascular access in the elderly patients who have more perioperative and postoperative complications and lower long-term patency rate compared with the young patients. Its long-term maintenance is also faced with many challenges. This article investigated the characteristics of vascular access and effective interventions in the elderly patients by analyzing the diagnosis and treatment of a patient who received maintenance hemodialysis in our center, providing reference for establishment and maintenance of the subsequent vascular access.

    • >Review
    • Micro ribonucleic acid in relation to the heterogeneous reactivity of antiplatelet drugs:progress and perspectives

      2018, 17(12):935-940. DOI: 10.11915/j.issn.1671-5403.2018.12.217

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      Abstract:Antiplatelet drugs play an established role in the prevention and treatment of cardiovascular and cerebrovascular events associated with atherothrombosis, but heterogeneous reactivity poses risks of serious ischemia or bleeding. Finding predictive biomar-kers of the heterogeneous reactivity of antiplatelet drugs is of great clinical value for their personalized use. Studies in recent years have found that platelets are a major source of miRNA, and much attention has been attracted to correlation between the platelet miRNA that can potentially regulate the expression of platelet P2Y12 and antiplatelet reactivity of P2Y12 receptor antagonists. This paper reviews the biological characteristic, correlation studies, and possible mechanisms of platelet microRNA in relation to reactivity of antiplatelet drugs.

    • Clinical characteristics of acute pancreatitis in the elderly

      2018, 17(12):941-944. DOI: 10.11915/j.issn.1671-5403.2018.12.218

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      Abstract:The aging society is threatened by a gradual increase of the incidence of acute pancreatitis, which warrants more attention both now and in the future. This review described its etiology, pathophysiology, clinical manifestations and complications, diagnostic paradigms, treatment and prognosis in the elderly, providing reference for the diagnosis and treatment of the disease.

    • Vascular risk factors and cognitive impairment in the elderly:a review

      2018, 17(12):945-948. DOI: 10.11915/j.issn.1671-5403.2018.12.219

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      Abstract:Cognitive impairment in the elderly is closely associated with the vascular risk factors, and such impairment is increasing year by year, posing a serious threat to the health among the elderly. Hypertension, diabetes mellitus, hyperlipidemia and chronic cerebral hypoperfusion are important vascular risk factors for cognitive functions in the elderly. It is, therefore, of medical and social significance in the early diagnosis and intervention to investigate the relationship between vascular risk factors and cognitive impairment in the elderly and the underlying mechanism.

    • Adverse effects of statins and prevention strategies in clinical application:a review

      2018, 17(12):949-951. DOI: 10.11915/j.issn.1671-5403.2018.12.220

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      Abstract:Statins have been widely used as a first-line drug therapy for cardiovascular and cerebrovascular diseases. The growing population on statins and number of related studies have raised greater concern about their risk of adverse effects on the skeletal muscles, liver and kidneys and its association with diabetes. In this review, we summarized the adverse effects of statins by exploring the literature available and propose prevention strategies, thus providing evidence for their clinical application.

    • Recent progress in research with animal models for age-related renal interstitial fibrosis

      2018, 17(12):952-955. DOI: 10.11915/j.issn.1671-5403.2018.12.221

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      Abstract:Interstitial fibrosis is the end-stage characteristic of chronic renal disease in the elderly and a common cause of renal failure. The use of animal models is essential for the understanding of the pathophysiology of renal interstitial fibrosis. The widely used animal models for this purpose include those with unilateral ureteral obstruction, subtotal nephrectomy, ischemia-reperfusion injury, cyclosporine A nephropathy, adriamycin nephropathy, stolochic acid nephropathy. These models were reviewed in this paper to provide a reference for the selection of a test method for better basic research.

    • Health management and prevention of cardiovascular disease in the elderly

      2018, 17(12):956-960. DOI: 10.11915/j.issn.1671-5403.2018.12.222

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      Abstract:The number of people with cardiovascular disease (CVD) has been rising, and individual exposure to cardiovascular risk factors has increased significantly in China. The elderly, as a special population group, has high morbidity and mortality of CVD, bringing about heavy social and economic burdens. Health management and prevention of CVD can effectively reduce its morbidity and mortality in the elderly, not only prolonging their lives but also improving their quality of life. Reasonable ways include lifestyle intervention, controlling and monitoring of blood pressure, blood lipids and blood sugar, as well as taking low-dose aspirin. Health management mode for the elderly patients with CVD warrants individualization and assessment of frailty, comorbidity, polypharmacy and personal preferences.

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创刊人:王士雯

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ISSN:1671-5403

CN:11-4786

创刊时间:2002

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邮发代号:82-408

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